The association between nurse staffing levels and paediatric nursing-sensitive outcomes in tertiary hospitals

Kim, Chul-Gyu; Kim, Ji-Soo

doi:10.1111/jonm.12627

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…Newly licensed nurses might experience excessive workload due to insufficient nurse staffing, thereby leading to a transition shock. The importance of nurse staffing in hospitals has been widely reported in terms of nurses' stress well as adverse patient outcomes as (Cho & Han, 2018; Griffiths et al, 2018; Kim & Kim, 2018). The present findings suggest that nurse staffing and resources are associated with even newly licensed nurses' transition shock.…”

Section: Discussionmentioning

confidence: 99%

Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study

Kim

2021

Journal of Clinical Nursing

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Aims and objectives To examine transition shock in newly licensed nurses and the association of work environment and resilience with nurses' transition shock. Background Although work environment is related to transition shock in newly licensed nurses, little is known about the factors of nursing work environment associated with transition shock. Furthermore, resilience is known to help nurses positively face workplace challenges; however, there is little evidence on the associations between resilience and transition shock in new nurses. Design A cross‐sectional, descriptive study. Methods Data from 163 new nurses with <12 months of work experience in the current hospital since graduation were analysed. Participants' characteristics, work environment, nurse resilience and transition shock were self‐reported. Multivariable linear regressions were performed in three steps (following the STROBE checklist). Results The highest mean score of transition shock was obtained for the item ‘I perceive the limitations of my professional knowledge in nursing care'. In the regression analysis adjusted for all variables, two factors of work environment—‘nurse staffing and resource adequacy’ and ‘collegial nurse‐physician relationships’—were associated with transition shock. Meanwhile, resilience was not related to transition shock. Conclusions The gap between newly licensed nurses' theoretical and practical knowledge continues to exist. Adequate nurse staffing and a positive relationship with physicians, rather than nurse resilience, were more likely to associate with new nurses' transition shock. Relevance to clinical practice Hospitals need to provide ward‐based simulations and case‐based learning methods to enhance nurses' transition to professional practice. For nurses' transition, hospitals should make efforts to provide adequate nurse staffing and resources. Furthermore, hospitals should provide communication opportunities to build a positive collaborative culture between nurses and physicians. Unit nurse managers need to assess newly licensed nurses' perception of nurse–physician professional relationship and create an atmosphere of respect and understanding for each other.

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Section: Discussionmentioning

confidence: 99%

Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study

Kim

2021

Journal of Clinical Nursing

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“…The included articles were performed in six countries, with the highest number (seven) conducted in North America (Connor et al., 2016; Graf, 2011; Kiss & Heiler, 2014; Lacey et al., 2006; Schwalenstocker et al., 2008; Stratton, 2008; Sullivan et al., 2021), three in Australia (Wilson et al., 2012a; Wilson et al., 2012b; Wilson et al., 2013c), and one in each of the following nations: China (Zhang et al., 2017), Ireland (Brenner et al., 2019), Korea (Kim & Kim, 2018), and South Africa (Coetzee et al., 2020). Of all the studies, seven focused on development (Brenner et al., 2019; Coetzee et al., 2020; Graf, 2011; Lacey et al., 2006; Schwalenstocker et al., 2008; Sullivan et al., 2021; Zhang et al., 2017), four focused on validation (Kim & Kim, 2018; Kiss & Heiler, 2014; Wilson et al., 2012a; Wilson et al., 2013c), and three aimed at both development and validation (Connor et al., 2016; Stratton, 2008; Wilson et al., 2012b) of NSOs. Six studies were cohort studies (Graf, 2011; Kim & Kim, 2018; Kiss & Heiler, 2014; Stratton, 2008; Wilson et al., 2012a; Wilson et al., 2013c ) and six were cross‐sectional surveys (Brenner et al., 2019; Connor et al., 2016; Lacey et al., 2006; Schwalenstocker et al., 2008; Wilson et al., 2012b; Zhang et al., 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Of all the studies, seven focused on development (Brenner et al., 2019; Coetzee et al., 2020; Graf, 2011; Lacey et al., 2006; Schwalenstocker et al., 2008; Sullivan et al., 2021; Zhang et al., 2017), four focused on validation (Kim & Kim, 2018; Kiss & Heiler, 2014; Wilson et al., 2012a; Wilson et al., 2013c), and three aimed at both development and validation (Connor et al., 2016; Stratton, 2008; Wilson et al., 2012b) of NSOs. Six studies were cohort studies (Graf, 2011; Kim & Kim, 2018; Kiss & Heiler, 2014; Stratton, 2008; Wilson et al., 2012a; Wilson et al., 2013c ) and six were cross‐sectional surveys (Brenner et al., 2019; Connor et al., 2016; Lacey et al., 2006; Schwalenstocker et al., 2008; Wilson et al., 2012b; Zhang et al., 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies (Kim & Kim, 2018; Wilson et al., 2012a; Wilson et al., 2013) used national administration data with a total sample size of 816 752 children. The remaining 11 studies (Brenner et al., 2019; Coetzee et al., 2020; Connor et al., 2016; Graf, 2011; Kiss & Heiler, 2014; Lacey et al., 2006; Schwalenstocker et al., 2008; Stratton, 2008; Sullivan et al., 2021; Wilson et al., 2012b; Zhang et al., 2017) had a total number of 1978 participants, which included children, nurses, pediatric experts, and pediatric care units.…”

Section: Resultsmentioning

confidence: 99%

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Pediatric nurse‐sensitive outcomes: A systematic review of international literature

Amatt

Marufu

Boardman

et al. 2022

International Nursing Review

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Background: Nurse-sensitive outcomes are measures for improvement and evaluation of the quality of nursing care delivered. The specific outcomes that need to be measured will be determined by the patient population, as well as the field and scope of practice, in which nursing care is being delivered. Currently, there is no internationally agreed upon set of nurse-sensitive outcomes for pediatric nursing, which provides specialist care to infants, children, and young people. Aim: To identify and evaluate nurse-sensitive outcomes for pediatric nursing. Methods: A systematic review was conducted. Five electronic databases (British Nursing Index, CINAHL, EMBASE, MEDLINE, and EMCARE) were searched in the period up to February 2022. Studies were selected for inclusion using title and abstract screening using predetermined criteria. The Critical Appraisal Skills Programme tool was used for quality assessment. A narrative synthesis of the results was performed. Results: A total of 633 studies were identified from online searches, with 14 studies meeting the inclusion criteria. All studies had moderate to high methodological strength. A total of 57 nurse-sensitive outcomes were identified from all included studies. Using the nurse-sensitive outcome conceptual analysis framework, 25 (45%) of the items were classified as outcome attributes, 20 (35%) as process attributes, and 13 (23%) as structure attributes. The most frequently reported nurse-sensitive outcomes included pressure ulcers, nosocomial infections, hospital-acquired infections, peripheral intravenous infiltration, failure to rescue, and staffing levels. Conclusions: This review provides an up-to-date and comprehensive list of nursesensitive outcomes for use in pediatric nursing and describes their frequency of use. However, further work is required to achieve consensus for an international core nursesensitive outcome set for pediatric nursing with policy recommendations to ensure agreed-upon minimum standards. Implications for nursing and health policy: Policy initiatives and guideline recommendations on nurse-sensitive outcome frameworks as part of patient safety should be a part of key priorities for policy makers. The commonly reported nurse-sensitive outcomes should be incorporated into daily bedside pediatric clinical nursing practice as a mechanism to evaluate and improve the quality of care, enhancement of patient safety, and better outcomes. K E Y WO R D S children and infant care, nurse-sensitive outcomes, nursing, pediatrics 

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“…This is consistent with other studies, to the extent that the nursing shortage is associated with increased rates of AEs, such as health care‐associated infections, falls and pressure ulcers, leading to increased length of hospital stay, readmission and mortality rates. In addition, it has impact on the efficiency, effectiveness and quality of care, increasing costs for patients, health professionals, health system and society in general (Aiken et al, ; Amiri & Solankallio‐Vahteri, ; Griffiths et al, ; Kim & Kim, ; Smeds‐Alenius, Tishelman, Lindqvist, Runesdotter, & McHugh, ; Wynendaele, Willems, & Trybou, ).…”

Section: Discussionmentioning

confidence: 99%

Nurse managers' perceptions of nurse staffing and nursing care quality: A cross‐sectional study

et al. 2020

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Aim To verify the association between the nurse staffing and the quality of nursing care, mediated by the care process, based on a hypothetical model, in Portuguese public hospitals. Background Nurse staffing influences health outcomes. Understaffing is associated with an increased risk for adverse events (AEs) and a reduction in the quality of care. Method A cross‐sectional study was conducted using a sample of 55 Portuguese nurse managers. A path model was developed to analyse potential causal mediation effects on care quality. Results Nurse staffing (number and competencies) and teamwork indirectly influence the quality of care. This process is mediated by the response capacity, the use of new techniques and work methods and patient's surveillance capacity. The AEs occurrence also has a mediating role, being negatively associated with the quality of care. Conclusions Optimizing nursing care safety and quality requires an adequate nurse staffing level, both in terms of number and competencies, as well as teamwork. Process components seem to play a mediating role in these relations. Implications for Nursing Management These results deserve the attention of nursing management for investment in the nursing staff and in the care process, to improve quality and create value in health care.

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The association between nurse staffing levels and paediatric nursing-sensitive outcomes in tertiary hospitals

Abstract: For quality paediatric nursing care, nurse staffing improvement is required. The study results could be useful evidence for appropriateness of nursing staffing in paediatric facilities.

Cited by 9 publications

References 19 publications

Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study

Association of work environment and resilience with transition shock in newly licensed nurses: A cross‐sectional study

Pediatric nurse‐sensitive outcomes: A systematic review of international literature

Nurse managers' perceptions of nurse staffing and nursing care quality: A cross‐sectional study

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